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Vieira MM, Peng S, Won S, Hong E, Inati SK, Thurm A, Thiam AH, Kim S, Myers SJ, Badger JD, Traynelis SF, Lu W, Roche KW. A Frameshift Variant of GluN2A Identified in an Epilepsy Patient Results in NMDA Receptor Mistargeting. J Neurosci 2024; 44:e0557232023. [PMID: 38050135 PMCID: PMC10860613 DOI: 10.1523/jneurosci.0557-23.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 08/24/2023] [Accepted: 11/14/2023] [Indexed: 12/06/2023] Open
Abstract
N-methyl-D-aspartate receptors (NMDARs) are crucial for neuronal development and synaptic plasticity. Dysfunction of NMDARs is associated with multiple neurodevelopmental disorders, including epilepsy, autism spectrum disorder, and intellectual disability. Understanding the impact of genetic variants of NMDAR subunits can shed light on the mechanisms of disease. Here, we characterized the functional implications of a de novo mutation of the GluN2A subunit (P1199Rfs*32) resulting in the truncation of the C-terminal domain. The variant was identified in a male patient with epileptic encephalopathy, multiple seizure types, severe aphasia, and neurobehavioral changes. Given the known role of the CTD in NMDAR trafficking, we examined changes in receptor localization and abundance at the postsynaptic membrane using a combination of molecular assays in heterologous cells and rat primary neuronal cultures. We observed that the GluN2A P1199Rfs*32-containing receptors traffic efficiently to the postsynaptic membrane but have increased extra-synaptic expression relative to WT GluN2A-containing NMDARs. Using in silico predictions, we hypothesized that the mutant would lose all PDZ interactions, except for the recycling protein Scribble1. Indeed, we observed impaired binding to the scaffolding protein postsynaptic protein-95 (PSD-95); however, we found the mutant interacts with Scribble1, which facilitates the recycling of both the mutant and the WT GluN2A. Finally, we found that neurons expressing GluN2A P1199Rfs*32 have fewer synapses and decreased spine density, indicating compromised synaptic transmission in these neurons. Overall, our data show that GluN2A P1199Rfs*32 is a loss-of-function variant with altered membrane localization in neurons and provide mechanistic insight into disease etiology.
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Affiliation(s)
- M M Vieira
- Receptor Biology Section, National Institute of Neurological Disorders and Stroke (NINDS), National Institutes of Health (NIH), Bethesda 20892, Maryland
| | - S Peng
- Synapse and Neural Circuit Research Section, NINDS, NIH, Bethesda 20892, Maryland
| | - S Won
- Receptor Biology Section, National Institute of Neurological Disorders and Stroke (NINDS), National Institutes of Health (NIH), Bethesda 20892, Maryland
| | - E Hong
- Receptor Biology Section, National Institute of Neurological Disorders and Stroke (NINDS), National Institutes of Health (NIH), Bethesda 20892, Maryland
| | - S K Inati
- Neurophysiology of Epilepsy Unit, NINDS, NIH, Bethesda 20892, Maryland
| | - A Thurm
- National Institute of Mental Health, National Institutes of Health, Bethesda 20892, Maryland
| | - A H Thiam
- Office of the Clinical Director, NINDS, NIH, Bethesda 20892, Maryland
| | - S Kim
- Department of Pharmacology and Chemical Biology, Emory University School of Medicine, Atlanta 30322, Georgia
- Center for Functional Evaluation of Rare Variants (CFERV), Emory University School of Medicine, Atlanta 30322, Georgia
| | - S J Myers
- Department of Pharmacology and Chemical Biology, Emory University School of Medicine, Atlanta 30322, Georgia
- Center for Functional Evaluation of Rare Variants (CFERV), Emory University School of Medicine, Atlanta 30322, Georgia
| | - J D Badger
- Receptor Biology Section, National Institute of Neurological Disorders and Stroke (NINDS), National Institutes of Health (NIH), Bethesda 20892, Maryland
| | - S F Traynelis
- Department of Pharmacology and Chemical Biology, Emory University School of Medicine, Atlanta 30322, Georgia
- Center for Functional Evaluation of Rare Variants (CFERV), Emory University School of Medicine, Atlanta 30322, Georgia
| | - W Lu
- Synapse and Neural Circuit Research Section, NINDS, NIH, Bethesda 20892, Maryland
| | - K W Roche
- Receptor Biology Section, National Institute of Neurological Disorders and Stroke (NINDS), National Institutes of Health (NIH), Bethesda 20892, Maryland
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Rice CE, Carpenter LA, Morrier MJ, Lord C, DiRienzo M, Boan A, Skowyra C, Fusco A, Baio J, Esler A, Zahorodny W, Hobson N, Mars A, Thurm A, Bishop S, Wiggins LD. Defining in Detail and Evaluating Reliability of DSM-5 Criteria for Autism Spectrum Disorder (ASD) Among Children. J Autism Dev Disord 2022; 52:5308-5320. [PMID: 34981308 DOI: 10.1007/s10803-021-05377-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/13/2021] [Indexed: 12/24/2022]
Abstract
This paper describes a process to define a comprehensive list of exemplars for seven core Diagnostic and Statistical Manual (DSM) diagnostic criteria for autism spectrum disorder (ASD), and report on interrater reliability in applying these exemplars to determine ASD case classification. Clinicians completed an iterative process to map specific exemplars from the CDC Autism and Developmental Disabilities Monitoring (ADDM) Network criteria for ASD surveillance, DSM-5 text, and diagnostic assessments to each of the core DSM-5 ASD criteria. Clinicians applied the diagnostic exemplars to child behavioral descriptions in existing evaluation records to establish initial reliability standards and then for blinded clinician review in one site (phase 1) and for two ADDM Network surveillance years (phase 2). Interrater reliability for each of the DSM-5 diagnostic categories and overall ASD classification was high (defined as very good .60-.79 to excellent ≥ .80 Kappa values) across sex, race/ethnicity, and cognitive levels for both phases. Classification of DSM-5 ASD by mapping specific exemplars from evaluation records by a diverse group of clinician raters is feasible and reliable. This framework provides confidence in the consistency of prevalence classifications of ASD and may be further applied to improve consistency of ASD diagnoses in clinical settings.
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Affiliation(s)
- C E Rice
- Emory University, Atlanta, GA, USA. .,Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | - L A Carpenter
- Medical University of South Carolina, Charleston, SC, USA
| | | | - C Lord
- University of California Los Angeles, Los Angeles, CA, USA
| | - M DiRienzo
- Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - A Boan
- Medical University of South Carolina, Charleston, SC, USA
| | - C Skowyra
- Washington University in St. Louis, St. Louis, MO, USA
| | - A Fusco
- Rutgers New Jersey Medical School, Newark, NJ, USA
| | - J Baio
- Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - A Esler
- University of Minnesota, Minneapolis, MN, USA
| | - W Zahorodny
- Rutgers New Jersey Medical School, Newark, NJ, USA
| | - N Hobson
- Independent Consultant, Keller, TX, USA
| | - A Mars
- Hunterdon Healthcare System, Flemington, NJ, USA
| | - A Thurm
- National Institute of Mental Health, Bethesda, MD, USA
| | - S Bishop
- University of California San Francisco, San Francisco, CA, USA
| | - L D Wiggins
- Centers for Disease Control and Prevention, Atlanta, GA, USA
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Jeste S, Hyde C, Distefano C, Halladay A, Ray S, Porath M, Wilson RB, Thurm A. Changes in access to educational and healthcare services for individuals with intellectual and developmental disabilities during COVID-19 restrictions. J Intellect Disabil Res 2020; 64:825-833. [PMID: 32939917 DOI: 10.1111/jir.12776] [Citation(s) in RCA: 119] [Impact Index Per Article: 29.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Revised: 08/17/2020] [Accepted: 08/18/2020] [Indexed: 05/17/2023]
Abstract
BACKGROUND COVID-19 restrictions have significantly limited access to in-person educational and healthcare services for all, including individuals with intellectual and developmental disabilities (IDDs). The objectives of this online survey that included both national and international families were to capture changes in access to healthcare and educational services for individuals with IDDs that occurred shortly after restrictions were initiated and to survey families on resources that could improve services for these individuals. METHODS This was an online survey for caregivers of individuals with (1) a genetic diagnosis and (2) a neurodevelopmental diagnosis, including developmental delay, intellectual disability, autism spectrum disorder or epilepsy. The survey assessed (1) demographics, (2) changes in access to educational and healthcare services and (3) available and preferred resources to help families navigate the changes in service allocation. RESULTS Of the 818 responses (669 within the USA and 149 outside of the USA), most families reported a loss of at least some educational or healthcare services. Seventy-four per cent of parents reported that their child lost access to at least one therapy or education service, and 36% of respondents lost access to a healthcare provider. Only 56% reported that their child received at least some continued services through tele-education. Those that needed to access healthcare providers did so primarily through telemedicine. Telehealth (both tele-education and telemedicine) was reported to be helpful when available, and caregivers most often endorsed a need for an augmentation of these remote delivery services, such as 1:1 videoconference sessions, as well as increased access to 1:1 aides in the home. CONCLUSIONS COVID-19 restrictions have greatly affected access to services for individuals with syndromic IDDs. Telehealth may provide opportunities for delivery of care and education in a sustainable way, not only as restrictions endure but also after they have been lifted.
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Affiliation(s)
- S Jeste
- Semel Institute for Neuroscience, UCLA, Los Angeles, CA, USA
| | - C Hyde
- Semel Institute for Neuroscience, UCLA, Los Angeles, CA, USA
| | - C Distefano
- Semel Institute for Neuroscience, UCLA, Los Angeles, CA, USA
| | - A Halladay
- Autism Science Foundation, New York, NY, USA
- Department of Pharmacology and Toxicology, Rutgers University, Newark, NJ, USA
| | - S Ray
- The Mighty, Glendale, CA, USA
| | | | - R B Wilson
- Semel Institute for Neuroscience, UCLA, Los Angeles, CA, USA
| | - A Thurm
- Neurodevelopmental and Behavioral Phenotyping Service, National Institute of Mental Health, NIH, DHHS, Bethesda, MD, USA
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Farmer C, Adedipe D, Bal VH, Chlebowski C, Thurm A. Concordance of the Vineland Adaptive Behavior Scales, second and third editions. J Intellect Disabil Res 2020; 64:18-26. [PMID: 31657503 PMCID: PMC6941197 DOI: 10.1111/jir.12691] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/24/2019] [Revised: 08/28/2019] [Accepted: 08/29/2019] [Indexed: 05/30/2023]
Abstract
BACKGROUND Because of its centrality in the conceptualization of intellectual disability, reliable and valid measurement of adaptive behaviour is important to both research and clinical practice. The manual of the Vineland Adaptive Behavior Scales, recently released in its third edition, provides limited reliability information obtained from a sample composed primarily of typically developing individuals. The goal of this study was to evaluate the concordance of the Vineland-3 with the Vineland-II in a sample more similar in ability level to those in which the Vineland is commonly used. METHODS Both editions of the Vineland Interviews were conducted with a convenience sample of 106 parents/caregivers of individuals with neurodevelopmental disability, participating at two neurodevelopmental disorder research clinics. Administrations were up to 7 days apart, but most (90%) were simultaneous. The concordance correlation coefficient (CCC) (95% confidence interval) and mean differences (95% confidence interval) were calculated for domain standard scores and subdomain v-scale scores. RESULTS Domain-level CCC ranged from 0.78 [0.70, 0.84] (Communication) to 0.86 [0.76, 0.92] (Motor). Subdomain CCC ranged from 0.71 [0.62, 0.78] (Receptive Language) to 0.91 [0.85, 0.95] (Fine Motor). Vineland-3 scores were lower than Vineland-II scores; 77% of participants had lower Adaptive Behavior Composite scores on the Vineland-3 than on the Vineland-II. For the subdomains, the magnitude of this difference depended upon the level of adaptive behaviour. For Communication, the domain with the lowest CCC, the mean difference ranged from -13.70 [-8.03, -19.35] for a Vineland-II score or 85 to a difference of -19.18 [-12.28, -26.87] for a Vineland-II score of 40. DISCUSSION Amongst individuals with intellectual and developmental disabilities, the Vineland-3 produces lower scores than the Vineland-II, and these clinically significant differences tend to be larger for individuals with lower levels of ability. Thus, care must be taken in interpreting scores from the Vineland-3 relative to those obtained from the previous edition.
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Affiliation(s)
- C Farmer
- Neurodevelopmental and Behavioral Phenotyping Service, Intramural Research Program, National Institute of Mental Health, Bethsada, MD, USA
| | - D Adedipe
- Neurodevelopmental and Behavioral Phenotyping Service, Intramural Research Program, National Institute of Mental Health, Bethsada, MD, USA
| | - V H Bal
- Graduate School of Applied and Professional Psychology, Rutgers University, New Brunswick, NJ, USA
| | - C Chlebowski
- Neurodevelopmental and Behavioral Phenotyping Service, Intramural Research Program, National Institute of Mental Health, Bethsada, MD, USA
| | - A Thurm
- Neurodevelopmental and Behavioral Phenotyping Service, Intramural Research Program, National Institute of Mental Health, Bethsada, MD, USA
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Cross JL, Iben J, Simpson CL, Thurm A, Swedo S, Tierney E, Bailey-Wilson JE, Biesecker LG, Porter FD, Wassif CA. Determination of the allelic frequency in Smith-Lemli-Opitz syndrome by analysis of massively parallel sequencing data sets. Clin Genet 2014; 87:570-5. [PMID: 24813812 DOI: 10.1111/cge.12425] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2014] [Revised: 05/07/2014] [Accepted: 05/07/2014] [Indexed: 01/18/2023]
Abstract
Data from massively parallel sequencing or 'Next Generation Sequencing' of the human exome has reached a critical mass in both public and private databases, in that these collections now allow researchers to critically evaluate population genetics in a manner that was not feasible a decade ago. The ability to determine pathogenic allele frequencies by evaluation of the full coding sequences and not merely a single nucleotide polymorphism (SNP) or series of SNPs will lead to more accurate estimations of incidence. For demonstrative purposes, we analyzed the causative gene for the disorder Smith-Lemli-Opitz Syndrome (SLOS), the 7-dehydrocholesterol reductase (DHCR7) gene and determined both the carrier frequency for DHCR7 mutations, and predicted an expected incidence of the disorder. Estimations of the incidence of SLOS have ranged widely from 1:10,000 to 1:70,000 while the carrier frequency has been reported as high as 1 in 30. Using four exome data sets with a total of 17,836 chromosomes, we ascertained a carrier frequency of pathogenic DHRC7 mutations of 1.01%, and predict a SLOS disease incidence of 1/39,215 conceptions. This approach highlights yet another valuable aspect of the exome sequencing databases, to inform clinical and health policy decisions related to genetic counseling, prenatal testing and newborn screening.
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Affiliation(s)
- J L Cross
- Program in Developmental Endocrinology and Genetics, Department of Health and Human Services, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health
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Tuval E, Thurm A, Rigbi Z. The Aging of Tires and Similar Objects in Open Air Storage. Journal of Polymer Engineering 1999. [DOI: 10.1515/polyeng-1999-0306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Abstract
Tires mounted on vehicles stored in the open air are subject to various forms of deterioration as a result of heat aging, oxidation and ozone attack, and must be protected by the use of chemical antidegradants, and if possible from direct sunlight. The effects of such deterioration on the properties of sidewall rubbers have been studied on tires of various ages taken from army stores, and certain conclusions have been drawn.
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Thurm A. Mental handicap nursing. "I've lost a good friend". Nurs Times 1989; 85:66-8. [PMID: 2771778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
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